Childhood chorea‐encephalopathy and unremarkable MRI: an association suggesting parvovirus B19 infection

Neuroinflammation, Neuroautoimmunity, and the Co-Morbidities of Complex Regional Pain Syndrome

“…These alternative etiologies should be considered before assigning a putative psychogenic etiology to any particular symptom. Self-limiting chorea, for instance, has been associated with Parvovirus B19 infection in children (Fong and de Sousa 2006; Grillo and da Silva 2009). In these cases, immune-mediated encephalopathies are thought to underlie the chorea, even though the MRI is unremarkable in these patients (Grillo and da Silva 2009).…”

Childhood chorea-encephalopathy associated with recent parvovirus B19 infection in two Jamaican children

“…4 His blood count, renal function tests, hepatic enzymes and CT and MRI brain scans were normal. Human PVB19 and cytomegalovirus DNA were detected in CSF by PCR.…”

“…3,4 The association was first described in an 8-yearold girl with a 4-day history of behavioural change, intermittent confusion and inappropriate giggling. 3 On the 1st day, she had mutism, abnormal limb postures and fluctuating consciousness followed by deterioration in language and motor function and the development of chorea, primarily of the face and upper limbs.…”

“…2 There have been recent reports of chorea encephalopathy associated with PVB19 infection in young children. 3,4 This report describes two Jamaican children with chorea encephalopathy associated with evidence of recent PVB19 infection. Informed consent for the publication of this report was obtained from the parents.…”

Treatment of Complex Regional Pain Syndrome (CRPS) Using Low Dose Naltrexone (LDN)

“…However, naltrexone has been used in HVC and HIV patients to treat opioid addiction, without causing major complications (Mitchell et al 2012). In general, before utilizing LDN in a given individual, practitioners should be aware that atypical cases of CRPS and movement disorders have been linked to infectious agents, such as Borrelia burgdorferi (Lyme disease) (Sibanc and Lesnicar 2002) and parvovirus B19 (Fong and de Sousa 2006; Grillo and da Silva 2009). The safety of using LDN to attenuate neuroinflammation, pain, and movement disorders, in these particular infectious diseases is unknown.…”